AB0661 NEUROPSYCHOLOGICAL OUTCOME OF CHILDREN BORN TO WOMEN WITH SYSTEMIC SCLEROSIS ASSESSED THROUGH A SELF-ADMINISTERED MULTIDISCIPLINARY QUESTIONNAIRE: RESULTS FROM A MONOCENTRIC COHORT
Authors: L. Moschetti, M. G. Lazzaroni, E. Pedretti, A. Bano, C. Nalli, F. Cucchi, A. Molinaro, J. Galli, E. Fazzi, F. Franceschini, A. Tincani, P. Airò, L. Andreoli
Journal: Annals of the Rheumatic Diseases (2022)

Background In the last years, the rate of successful pregnancies has significantly increased in Systemic Sclerosis (SSc) 1 women. However, the long-term outcome of their children remains an unexplored issue. Objectives To evaluate the neuropsychiatric (NP) outcome of children born to SSc mothers. Methods An ad-hoc questionnaire, regarding different aspects of child’s neurodevelopment (ND) (3 sections: childhood [0-5 years]; scholar age [6-11 years]; adolescence [12-18 years]), was created and administered to female SSc patients (ACR/EULAR 2013 criteria) attending our outpatient clinic during 2021 and who had at least 1 child. Children’s NP characteristics were compared between 3 subgroups: A) born &gt;10 years before SSc diagnosis; B) born ≤10 years before SSc diagnosis; C) born after SSc diagnosis. Results below are expressed as number/total number of answers collected for each question. Results 100 SSc women reported 189 pregnancies: 152 resulted in 154 live births (2 twin pregnancies). At least one NP alteration was reported in 42/119 (35%) subjects, more frequently in group B (57%), as compared to group A (31%, p:0.07 ) and group C (30%, p:0.09 ) although not statistically significant (Figure 1). Sleep irregularities were the most frequently reported disorder (15/42, 36%). Comparisons between the 3 subgroups for every NP outcome evaluated are shown in Table 1: overall, a higher rate of NP alterations were reported in children belonging to group B. Table 1. Analysis of NP outcomes: comparison of the 3 subgroups. A n=103 B n=19 C n=32 N° of subjects evaluated forDISORDERS IN CHILDHOOD 103/103 19/19 32/32 Sleep irregularities 6/79 (8)* 4/13 (31)* 5/27 (19) Motor difficulties 0/77 (3)° 2/13 (15)° 2/26 (8) Difficulty in relationships 0/78 (0) 1/11 (9) 2/26 (8) Difficulty in non-verbal communication skills 0/78 (0) 1/11 (9) 2/26 (8) Difficulty in verbal communication skills 1/77 (1) 1/12 (8) 2/26 (8) Difficulty in social integration 6/77 (8) 3/12 (25) 1/25 (4) Cognitive difficulties 0/77 (0) 1/12 (8) 0/26 (0) N° of subjects evaluated forDISORDERS IN SCHOLAR AGE 103/103 17/19 17/32 Difficulty in school lessons/homework 7/77 (9) 3/12 (25) 0/15 (0) Behavioral problems during school period 4/76 (5) 1/12 (8) 1/15 (7) School year repetition 11/76 (15) 2/13 (15) 0/15 (0) N° of subjects evaluated forDISORDERS IN ADOLESCENCE 101/103 14/19 11/32 Difficulty in managing anger and aggression 4/75 (5) 0/11 (0) 0/10 (0) Behavioral alterations 0/75 (0) 0/11 (0) 0/10 (0) Difficulty in conduct 2/73 (3) 0/11 (0) 2/10 (20) Mood alterations 1/73 (1) 1/11 (9) 0/10 (0) Alterations of the feeding behavior 1/75 (1) 0/11 (0) 0/10 (0) Anxiety problems 1/75 (1) 1/10 (10) 0/10 (0) Results are presented as number/total number (%) of answers collected for each question. Variables were compared with Chi Squared/exact Fisher test. * p=0.03 ; ° p=0.02 . Figure 1. Children with ≥1 NP alteration: comparison of the 3 subgroups. In addition, SSc mothers declared that 7/123 (6%) children underwent a NP evaluation leading to a diagnosis in 3 cases: 1 cognitive delay, 1 learning disorder (LD) and 1 autism spectrum disorder (ASD). These children were born 1 and 5 years before and 3 years after SSc diagnosis, respectively. The prevalence of these diagnoses (0.8%) does not differ from general pediatric population. Conclusion Children born to SSc mothers, had prevalence of major NP alterations (cognitive deficits, LDs, ASDs) similar to general pediatric population. A higher frequency of minor ND disorders, especially sleep irregularities, was observed in children within 10 years before maternal diagnosis, compared to the other groups, possibly suggesting an impact of maternal chronic disease on the relationship with child in the first years of life. To confirm these self-reported preliminary data, the extension of the study will consist in a systematic NP evaluation proposed to all the offspring of SSc mothers aged ≤18 years. References [1]Blagojevic J et al . 2019. J Rheumatol. Acknowledgements GILS (Gruppo Italiano Lotta Sclerodermia) is kindly acknowledged for supporting the study with a grant. Disclosure of Interests None declared